Healthcare Provider Details

I. General information

NPI: 1689181653
Provider Name (Legal Business Name): BRITTANY MESSINA LBA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 E MUIRWOOD DR STE 103
PHOENIX AZ
85048-7693
US

IV. Provider business mailing address

8645 N PLEASANT VALLEY WAY
FLAGSTAFF AZ
86004-3224
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-6981
  • Fax: 480-898-7419
Mailing address:
  • Phone: 716-450-0312
  • Fax: 480-898-7419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: